title: [Intracranial dural arteriovenous fistula with perimedullary venous drainage: Anatomical, clinical and therapeutic considerations about one case, and review of the literature].
abstract: Intracranial dural arteriovenous fistulae with perimedullary venous drainage are unusual type of vascular brain malformations. Patients may present with a rapidly progressive ascending myelopathy associated with autonomic dysfunction, which can cause a misdiagnosis and delay the therapeutic management. These clinical signs must be quickly recognized to avoid a poor outcome. The authors report the case of a 60-year-old woman presenting with a progressive myelopathy due to a dural arteriovenous fistula with perimedullary venous drainage. The diagnosis was suspected on brain-spinal MRI and confirmed by brain arteriography visualizing the arteriovenous shunt in the middle segment of the superior petrous sinus. MRI showed edema in the medulla oblongata. The treatment was performed early by endovascular glue embolization of the arteriovenous shunt and of the origin of the vein. Brain arteriography and clinical follow-up, one month later, showed complete disappearance of the dural fistula and regression of clinical symptoms. MRI control showed the reduction of the brain stem edema. Because of the early pejorative prognosis of these kinds of fistulae, early diagnosis and treatment are needed.
authors.affiliation: Service de neurochirurgie, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94000 Créteil, France. mathon.bertrand@neuf.fr
authors.forename: B
authors.initials: B
authors.lastname: Mathon
authors.forename: S
authors.initials: S
authors.lastname: Gallas
authors.forename: T
authors.initials: T
authors.lastname: Tuillier
authors.forename: O
authors.initials: O
authors.lastname: Bekaert
authors.forename: P
authors.initials: P
authors.lastname: Decq
authors.forename: P
authors.initials: P
authors.lastname: Brugieres
authors.forename: A
authors.initials: A
authors.lastname: Nouet
authors.forename: A
authors.initials: A
authors.lastname: Gaston
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002343:Carotid Artery, Internal / Q000473:pathology / Q000601:surgery; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy*; D002533:Cerebral Angiography; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009460:Neurologic Examination; D019635:Neurosurgical Procedures; D011379:Prognosis; D013116:Spinal Cord / Q000473:pathology*; D016896:Treatment Outcome
keywords: Atypical spinal compression; Colle; Compression médullaire atypique; Diagnostic différentiel syndrome de Guillain-Barré; Differential diagnosis of Guillain-Barré syndrome; Drainage veineux périmédullaire; Dural arteriovenous fistulae; Embolisation; Fistule durale intracrânienne; Glue embolization; Perimedullary drainage; Type V